With hours left until the state legislature goes home, Louisiana Republicans are trying to shoot themselves in the foot — and cost their constituents a lot of money — by banning pharmacies in the state from owning Pharmacy Benefit Managers (PBMs).

Like a lot of political moves, it sounds good on the surface. The company the bill will most impact is CVS, a corporation. PBMs, which are middlemen in the drug industry, aren’t very transparent with their prices. And lawmakers get to say they protected constituents from high drug prices.

There’s only one problem: PBM politics are very good. But PBM economics are not.

First up: jobs. CVS is putting out the word that the ban will force the company to close over 100 stores, costing about 2,700 people their jobs. These aren’t low-paying jobs, either; CVS raised its minimum wage to $15 per hour in 2021, but many employees are store managers and pharmacists — and the latter make over three times that hourly income. Plus the benefits, which are about what you’d expect for a national healthcare company.

Second: access. In the Virginia suburbs where I live, there are almost as many pharmacies as Starbucks locations. I’m sure that’s true in the New Orleans and Baton Rouge metro areas — but what about in rural towns? In many regions, there are only one or two pharmacies that can navigate the complex drug system to find low-cost drugs — often a CVS location. Driving further to other pharmacies would create logistical and financial difficulties for many rural residents, especially those who are already cash-strapped or limited by physical disability.

Third: PBMs actually do lower prices. Yes, they’re opaque. No, they’re not perfect. But as one of CVS’s competitors noted in a response to the Federal Trade Commission’s lawsuit against PBMs, it is not the middleman who sets a drug’s price — it’s the manufacturer. It’s a PBM’s job to get that price as low as possible, something the industry credibly says it does.

Republicans, especially in conservative states like Louisiana, often tout their support for the free market. They should know that the government, not PBMs, is the problem here. Specifically, government interference in the market — like, say, the Affordable Care Act’s insurance profit limits that encouraged companies to vertically integrate. If Louisiana follows Arkansas’s path in making PBMs the enemy, you can almost guarantee that a) choice will go down, b) prices will go up, and c) politicians of both parties will find new enemies to blame.

Perhaps that’s why lawmakers introduced, and voted on, the bill a day before the end of the session. They know they’re creating a boogeyman — and they want to gavel out and go home before people know what’s happening.

Image: Free image, Pixabay license.